| Harbor Hall, Inc. | |
|
2236 E Mitchell Rd Petoskey MI 49770-9604 | |
| (231) 347-9880 | |
| Not Available |
| Full Name | Harbor Hall, Inc. |
|---|---|
| Speciality | Family Medicine |
| Location | 2236 E Mitchell Rd, Petoskey, Michigan |
| Authorized Official Name and Position | Kayla Jane Pennington (OFFICE MANAGER) |
| Authorized Official Contact | 2313475511 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Harbor Hall, Inc. 704 Emmet St Petoskey MI 49770-2910 Ph: () - | Harbor Hall, Inc. 2236 E Mitchell Rd Petoskey MI 49770-9604 Ph: (231) 347-9880 |
| NPI Number | 1851865638 |
|---|---|
| Provider Enumeration Date | 01/15/2019 |
| Last Update Date | 02/29/2024 |
| Certification Date | 02/29/2024 |
| Medicare PECOS PAC ID | 8123453065 |
|---|---|
| Medicare Enrollment ID | O20200122002826 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1851865638 | NPI | - | NPPES |
| SA0240037 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | (* (Not Available)) | Secondary |
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Martin P Jankowski |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1790834943 PECOS PAC ID: 0244206076 Enrollment ID: I20040902001385 |
| Provider Name | Stephanie C Veling |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1225046295 PECOS PAC ID: 7911001813 Enrollment ID: I20070403000179 |
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